Nursing Students’ Information Literacy Skills

Prior to and After Information Literacy Instruction

Dr. Cheryl Perrin

University of Southern Queensland
Toowoomba, AUSTRALIA 4350
E-mail: perrin@usq.edu.au
Phone: 07 4631 2931

Dr Delwar Hossain
University of Southern Queensland
Toowoomba, AUSTRALIA 4350
E-mail: hossain@usq.edu.au
Phone: 07 4631 5443

Ms Kaye Cumming
University of Southern Queensland
Toowoomba, AUSTRALIA 4350
E-mail: cumming@usq.edu.au
Phone: 07 4631 4672

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ABSTRACT

Information literacy has been identified by the University of Southern Queensland as an

essential graduate quality. It has also been identified in the nursing literature as a
requirement for nursing profession. Data were collected from Toowoomba and Fraser
Coast campuses using a questionnaire to assess first-year nursing students’ information
literacy skills prior to and after information literacy instruction. The findings indicate that
embedding such instruction into nursing courses is beneficial.
Key words: Information literacy instruction, embedding, problem solving, confidence,
information access skills.

INTRODUCTION

According to Jacobs, et al. (2003), an information literate person possesses “…an

understanding of the architecture of information and the scholarly process; the ability to
navigate among a variety of print and electronic tools to effectively access, search, and
critically evaluate appropriate resources” as well as the capacity to organise
“…accumulated information into an existing body of knowledge; communicate research
results clearly and effectively; and appreciate the social issues and ethical concerns
related to the provision, dissemination, and sharing of information.”. Through a
collaborative approach involving the University Library, and the Learning and Teaching
Support Unit, the USQ Department of Nursing and Midwifery has embedded information
literacy instruction into the first year of the nursing curriculum in order to introduce
students to these essential professional skills. The aim of this study was to (i)
determine the information literacy skills and confidence of students entering the USQ to
Bachelor of Nursing Program; (ii) to establish if information literacy skills and confidence
improve as a result of embedding information literacy instruction into a first semester,
first year nursing course; and iii) ascertain whether there were any differences in
information literacy skills and confidence based on the students demographic profiles.

LITERATURE REVIEW

The acceptance of information literacy skills as an essential quality of undergraduates is

widespread (Hartmann, 2001; Jacobs et al., 2003; Shorten et al., 2001). Being able to
locate, retrieve, assess and adequately use information has always been an important
part of learning particularly in an academic setting. However, education facilities need to
provide students with the necessary skills to navigate their way through the various
information pathways, both online and otherwise. Moreover, in a nationwide review of
nursing education (National Review of Nursing Education, 2002) it was put forward that
for future nursing professionals to be effective in “the current climate of technological

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change “…it is crucial that they are able to maintain their competence” and “…develop it
through lifelong learning”. To achieve
this nursing students need the ability to assess and utilise the information found in a
meaningful and applied manner.

In the literature on information literacy and the nursing profession (Shorten, et al. 2001)
found that integrating information literacy instruction into nursing curricula increases
students’ confidence. This was validated by the work of a New Zealand research team
(Honey, et al. 2006) who found that embedding information literacy programs into the
curriculum, rather than running classes as extra- or inter-curricula, was most beneficial
for nursing students. Low confidence levels in students is known to adversely affect
their learning abilities and information seeking behaviour (Barnard, et al. 2005). Croke
(2004) explained that when nursing students were feeling confident in their abilities,
they were increasingly able to engage in self-directed learning. This would appear to
bolster the presumption that if confident, students will apply their information literacy
skills to clinical practice. The literature is clear that information literacy is an essential
skill required by nursing professionals (Shorten et al., 2001) in order to provide
evidence-based health care.

Research supports the practice of embedding information literacy programs into

curricula (Honey, et al. 2006; Shorten, et al. 2001). While there has been some
research into the most effective modes on delivering information literacy instruction in
universities, there is scant research available as to continuing efficacy, or whether or not
such learning is applied in the professional arena. This preliminary study attempts to
bridge this gap in the knowledge by evaluating nursing students’ information literacy
skills prior to and after information literacy instruction.

METHODOLOGY

After gaining ethics approval to conduct the study data were sourced from both the
Toowoomba and Fraser Coast campus nursing students. The students were all
enrolled in a compulsory first-year, first semester nursing course (xxxx) that is a pre-
requisite to a follow-on second semester clinical based nursing course(xxxx). Prior to
information literacy instruction involving a lecture and tutorials conducted by university
librarians a questionnaire were used to assess the first-year nursing students’
information literacy skills. A plain language statement explaining the purpose of the
study, consent form, and the questionnaire were distributed to all first year nursing
students who were in attendance at a lecture in first semester 2007. The same cohort
of students were approached post information literacy instruction in a similar lecture
situation in semester two. The overall response rate in both campuses was 45 and 56
percent respectively.

The questionnaire used was based on the work of Neely (2000) and Tweedale (2006)
and was endorsed by the USQ Learning and Teaching Enhancement Committee

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(LTEC). Both closed and open-ended questions were included to determine the
technical skills, confidence in, and awareness of information access of the students.
The students indicated their responses to each of the statements on a five-point Likert-
type scale (5= strongly agree, 4=agree, 3= undecided, 2= disagree, and 1= strongly
disagree). Data were analysed using the SPSS 14.0 for Windows. Frequency counts
and percentages as well as means and standard deviations were calculated for the
descriptive data. Appropriate tests were used to determine whether there were
significant differences between the groups of students with regards to their information
literacy skills based on age, sex, country of origin, highest level of education completed
prior to enrolment in the nursing program, prior training on finding and using information
and online computer access at home.

The resulting differences in information literacy skills were tested for significance at 0.05
level of probability with an accompany 95% confidence level. For comparing the
preference of sources of nursing information of the students, preference indices have
been shown in the contingency Table 2. Preference index of information sources was
computed by using the following formula:
Preference index = P1st x 1 + P2nd x 2 + P3rd x 3 + P4th x 4 + P5th x 5
Where,
P1st = Percentage of students indicating the nursing information source as their first
preference
P2nd = Percentage of students indicating the nursing information source as their second
preference
P3rd = Percentage of students indicating the nursing information source as their third
preference
P4th = Percentage of students indicating the nursing information source as their fourth
preference
P5th = Percentage of students indicating the nursing information source as their fifth
preference
The possible range of preference indices could be from 100 to 500, where 100 indicated
highly preferred sources of information and 500 indicated the least preferred sources of
information.

RESULTS
Demographic profile of the students

The majority of the students (79%) were from the Toowoomba campus as compared to
21% from the Fraser Coast campus. The highest proportion of students (28%) was
between 16 and 18 years of age compared to 26% aged 31 years and above. The
majority of respondents were female (88%) and Australian (83%). International
students comprised 17% of the respondents. The highest proportion of respondents
(72%) stated secondary school as their entry level of education. Almost half (49%) of
students had not participated in classes on finding and using information. Over three

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quarters (77%) of the students had online computer access at home to use whenever
needed.

Information literacy of first year nursing students

The students agreed that accessing information was part of their problem solving skills
and their confidence and awareness of information literacy increased between
semesters one and two (Table 1).

Semester Semester
Area of Information access one two
Mean SD Mean SD
Problem solving skill 4.14 .54 4.02 .71
I usually try to find information as the first step in
4.04 .65 3.95 .85
solving an everyday problem
I usually try to find information as the first step in
4.26 .63 4.11 .81
solving a nursing problem
Confidence in ability 3.71 .60 4.06 .63
I am able to find nursing information in the USQ
3.76 .87 4.13 .85
library
I am able to find nursing information in another
3.48 .84 3.62 .93
library (hospital, other university)
I am able to find nursing information by using the
3.76 .84 4.27 .77
Library database
I am able to find nursing books using the Library
3.75 .89 4.04 .92
catalogue
I am able to find nursing journals using the Library
3.78 .70 4.16 .83
catalogue
I am able to locate nursing information using
3.77 .87 4.24 .72
computer search engines
Awareness 4.38 .55 4.46 .53
I am aware that any first search results may not
4.30 .66 4.40 .60
give me the information I require
I am aware that the responsibility for self learning
4.46 .61 4.52 .58
rests with myself
Table 1 Mean and standard deviation of information literacy of the nursing students

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Information literacy based on the students’ demographic profile

There were no significant differences in information literacy skills according to highest

level of education prior to enrolling in the nursing program. The students who had
attended classes on finding and using information prior to their enrolment in the
program reported higher problem solving skills, confidence and awareness of
information literacy and responsibility for self-learning. Those students who had online
computer access at home had higher information literacy skills than those who had no
home access.

Female students were slightly more robust in problem solving skills and confidence in
their ability to access information. They also demonstrated significantly higher mean
ratings in awareness of information than their male counterparts. Similarly, overseas-
born students exhibited marginally greater problem solving skills and higher confidence
in information literacy ability compared to students from Australia. However, Australian
students were more aware of information literacy. As age increased, so did students’
problem-solving skills and confidence using Library resources and Internet search
engines.

Preference of nursing students’ information sources

In semester one the most preferred information source was the search engine “Google”
followed by “Nursing Journals”; whereas in second semester “Nursing Textbooks”
surpassed “Google” for first preference (Table 2).

Level of preference
Total
Nursing 1s 2n 5t percen Inde
information source N t d 3rd 4th h t x Rank
Semester 1
Google 87 64 7 3 13 13 100 204 1
Nursing Journals 63 21 55 14 6 4 100 217 2
Nursing Textbooks 92 30 27 36 7 0 100 220 3
Library Databases 90 18 8 34 38 2 100 298 4
Librarian 65 2 2 5 24 67 100 452 5
Semester 2
Google 114 22 5 10 25 38 100 352 3
Nursing Journals 114 21 44 20 8 7 100 236 2
Nursing Textbooks 114 30 29 23 15 3 100 232 1
Library Databases 114 26 16 37 15 6 100 259 4

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 Librarian 114 0 6 9 39 46 100 425 5
Table 2 Percentage distributions of students according to their level of preference in
nursing information source and rank
Further, in both semesters the students preferred “The bibliography” as a source for
finding additional information from a relevant journal article. However, in semester two,
students’ second preference was “keywords”, compared to “the index” in semester one
(Table3).
Source of Level of preference
publications to the Total
article N 1st 2nd 3rd 4th 5th percent Index Rank
Semester 1
The bibliography 79 60 20 6 5 9 100 183 1
The index 62 35 23 26 11 5 100 228 2
The keywords 65 31 25 17 21 6 100 246 3
The table of contents 58 24 22 24 16 14 100 274 4
The abstract 58 22 12 12 19 35 100 337 5
Semester 2
The bibliography 107 38 13 13 11 25 100 272 1
The index 106 16 21 17 26 20 100 313 4
The keywords 107 21 28 20 17 14 100 275 2
The table of contents 106 4 14 29 27 26 100 357 5
The abstract 109 24 24 20 16 16 100 276 3
Table 3 Percentage of preference in seeking further relevant publications to a given
article

Citation recognition
With regard to recognising a journal article citation, the highest proportion (53%) of the
students indicated the correct answer in semester one. This increased to 68% in
semester two.

DISCUSSION

Problem solving skills

The comparison of information literacy skills showed minor decreases in problem

solving skills between semesters one and two. This might not be a true reduction of
actual skills because of the knowledge gained in semester two. Students may have
become more aware of the set of skills necessary to use information literacy in their
problem solving, resulting in a clarification of their perceptions. This was akin to
Hartmann’s (2001) finding regarding students’ confusion of information literacy with

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computer literacy, which Hartmann attributed to their misconceptions about the nature
of information literacy.

Based on analysis of the data, it was evident that using information as a first step in
problem solving was a skill that increased with age. This is congruent with the notion
that age impacts positively on problem solving skills (Ip et al., 2007). Students who
were from countries other than Australia displayed more strength in their problem
solving skills. This could be related to several factors such as higher levels of education
and attendance at information classes prior to enrolling in nursing. Students who had
readily available online computer access at home had better problem-solving skills
related to information literacy than those who did not.

Confidence in ability

Increases in students’ confidence positively effects information seeking behaviours

(Barnard et al., 2005). The confidence of the first year nursing students increased from
semester one to semester two. This is to be expected given the students’ increased
exposure to learning experiences (Booth, 2006; Croke, 2004; Hartmann, 2001) as well
as embedded information literacy instruction in the curriculum. These increases were
significant in all areas measuring information literacy confidence with the exception
being confidence in the ability to find information in another library. This could be due to
the students having little or no exposure to libraries other than their university library.

No significant differences were found in most areas of information literacy according to

whether or not students had attended classes on finding and using information prior to
enrolling in the nursing program. Differences that were found related to students’
confidence in their ability to use the library catalogue. In this case, those students who
were unsure about whether or not they had attended classes prior to enrolling at
university were less confident in their ability compared to those students who had
attended such classes. This might be a factor which inhibited their ability to access
information. This thought is reinforced by Croke (2004), who states that as students’
confidence increases, so does their propensity to engage in self-directed learning.

The confidence levels of students with readily available online computer access at
home were small but persistently higher than those students without online access at
home. This could be due to more exposure to online sources of information.

A cross-analysis of data revealed that students’ confidence in their information access

abilities increased, then plateaued at the 22-30 year age group and receded after this.
The 31 years and above age group was least confident in finding information using
library databases and computer search engines even though they had the highest level
of at home online access in proportion than the other age groups. Likewise Ip, et al.
(2007) stated that the acceptance of computer literacy is generally positive in the late
teens to early 20’s age cohorts.

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Awareness of information literacy

Those students who were unsure about whether or not they had attended pre university
information literacy classes were less aware than those students who had attended
classes. Students were aware of the fact that first search results may not have provided
the information they required. Contrast analysis yielded significant results showing
higher levels of awareness of information literacy in the group of students with readily
available online computer access at home when compared to the students who had no
such access. In part this may be because those students with convenient online access
at their homes have more exposure to searching for information using Internet search
engines.

Based on the analysis of data it was evident that male students were significantly less
aware than female students regarding information access overall, and particularly less
aware that the onus for self learning rests with the individual themselves. As stated, the
highest level of education attained prior to enrolling in the Nursing program had no
significant impact on information literacy.

Preferred sources of information

In semester one, the preferred location for sourcing nursing information was the
“Google” search engine. This preference changed to “Nursing Textbooks” in semester
two. Such a change is to be expected, given that the initial questionnaire was
administered relatively early in semester one, and students would have become
considerably more familiar with their texts by the time the second questionnaire was
handed out in semester two.

The order of preference for the listed options to seek further information from a “relevant
journal article” also changed from semester one to semester two. “The bibliography”
was the first choice in both semesters although “the abstract” went from being last
choice in first semester to third choice in semester two. This increase in the use of “the
abstract” as a preference was significant, particularly for those students who attended
classes on finding and using information. Cross-tabulation found that this group
compared more positively with those who did not attend classes. This may reflect
increased student knowledge and familiarity with academic literature acquired through
attending information literacy classes.
There was a significant increase in the percentage of students choosing the correct
journal article citation. This increase was most prominent, as discovered in cross-
tabulations, with the students who had convenient online computer access at home.
Attendance at classes for finding and using information did not have a positive impact
on students’ choices of the correct citation. There was a slight decrease in choosing the
correct citation, from semester one to semester two, for those students who attended
classes. This would infer that while classes have increased students’ confidence in their

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information literacy skills, they did not necessarily gain adequate knowledge to enable
them to correctly recognise journal citations. “Prior education” was the next factor,
where students that had completed secondary school chose the correct citation by an
increase of 15 per cent between semesters one and two.

CONCLUSIONS

Embedding information literacy instruction into the first year nursing program is
beneficial. As information literacy instruction is embedded into the first year nursing
courses, students’ confidence and awareness is positively affected by their increased
exposure to information literacy in the nursing context. Attendance at information
literacy classes improved students’ confidence in their abilities to find relevant
information and to engage in self-directed learning. Additionally, exposure to the various
sources of information increased students’ awareness of the scope of information.

Given this evidence, the collaborative approach towards embedding information literacy
instruction between the Department of Nursing and Midwifery, the Library and the
Learning and Teaching Support Unit ought to be continued throughout the subsequent
years of the nursing program. This will improve students’ problem solving skills,
confidence in their abilities and awareness of information literacy.

REFERENCES

Barnard, A., Nash, R., & O'Brien, M. (2005). Information literacy: developing lifelong
skills through nursing education. Journal of Nursing Education Vol. 44(11), 505-510.
Booth, R. G. (2006). Educating the future health professional nurse. International
Journal of Nursing Education Scholarship, Vol. 3(1), 1-12.
Croke, E. (2004). The use of structured reflective journal questions to promote
fundamental development of clinical decision-making abilities of the first-semester
nursing student. Contemporary Nurse, 17(1-2), 125-136.
Hartmann, E. (2001). Understandings of Information Literacy: The Perceptions of First-
Year Undergraduate Students at the University of Ballarat. Australian Academic &
Research Libraries, 32(2), 110-122.
Honey, M., North, N., & Gunn, C. (2006). Improving library services for graduate nurse
students in New Zealand. Health information & libraries journal, Vol. 23(2), 102-109.
Ip, B., Jones, S., & Jacobs, G. (2007). Retention and application of information
technology skills among nursing and midwifery students. Innovations in education &
teaching international Vol. 44(2), 199-210.
Jacobs, S. K., Rosenfeld, P., & Haber, J. (2003). Information literacy as the foundation
for evidence-based practice in graduate nursing education: a curriculum-integrated
approach. Journal of Professional Nursing, Vol. 19(5), 320-328.
National Review of Nursing Education. (2002). National review of nursing education
2002: Our duty of care. Retrieved September 6, 2007, from
http://www.dest.gov.au/archive/highered/nursing/pubs/duty of care/default.html.

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Neely, T. Y. (2000). Sociological and psychological aspects of information literacy in
higher education Unpublished Doctoral Dissertation, University of Pittsburgh.
Shorten, A., Wallace, C., & Crookes, P. A. (2001). Developing information literacy: a key
to evidence-based nursing. International Nursing Review, 48(2), 86-92.
Tweedale, R. (2006). University of Southern Queensland Information Literacy Strategy:
Endorsed by the University Of Southern Queensland Learning and Teaching
Enhancement Committee. 6 April 2006 [Electronic Version]. Retrieved May 2006 from
http://www.usq.edu.au/resources/ilstrategyapril2006/pdf.

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